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Tuesday, April 1, 2014

Does performing euthanasia contribute to suicide risk for veterinarians?

Euthanasia can take an emotional toll on vets.

Last week I interviewed
one of the investigators of a study exploring the association between the
frequency of euthanasia performed and depressed mood/suicide risk in
veterinarians. I find this particularly interesting because vets have an
increased suicide rate (reportedly 4x that of the general population) and
according to investigator Dr Monique Crane, “it is generally believed that the
key contributor to this behaviour is the euthanasia of animals.”

It’s a powerful argument.
People become vets because they love animals, then they have a job which
involves – to some degree or other – ending animal lives. That’s not what we
signed up for!!!

But…while euthanasia can
be stressful, emotionally taxing and a whole bucketful of other things this
assumption didn't entirely ring true to me. So I was interested to find out
about the research.

The investigators include
a registered psychologist (Crane) – who researches occupational mental health
and resilience; a former vet now medical researcher (Professor Jacqueline
Phillips) and a research masters student (Lily Tran).

For this study, published
in the Journal of Occupational Health
Psychology, the team surveyed 540 vets ranging from 23 to 74 years in age.

Not surprisingly, they
found that the more one performed euthanasia in an average working week, the greater
the risk of depressed feelings.

BUT what they found was
euthanasia frequency only explained a small amount of variance in depressed
mood.

“This indicates that the
performance of euthanasia is a very minor player in depression experienced by
veterinarians and other factors are likely to make much more of a contribution.”

And perhaps the most
startling finding is that the more euthanasia
performed in the average working week, the LESS suicide risk in depressed vets.
So, instead of contributing to a higher suicide risk, a high frequency of
euthanasia was protective against suicide.

How can it be? I think we
need to remember first why we perform euthanasia. In most cases it is to end
suffering. There are of course the “convenience” or “objectionable” euthanasia –
I would argue that these don’t qualify for the term euthanasia (that is a whole
other discussion). But generally, although it is very sad, we do it because we
are doing some good. Giving an animal a controlled, peaceful end. While it is
heartbreaking, it is also often a time when we are able to support our clients.

I’ve shed plenty of tears
at work, for animals, for their owners, for the loss and grief I see, but
bringing about a peaceful death is a meaningful and worthy task.

Personally I feel that
this is a privilege – a chance to be there for an animal, and often the family,
when there is a need for comfort. Unlike managing a complex medical or surgical
case, the outcome is certain. Owners are often very frank about their bond with
their animal at this time. It is a reminder of the value of life, and why we do
what we do. People often say “this must be the worst part of your job”, but it
isn’t. For example, I find intractable suffering much harder to cope with.

So what are the other
factors? The study also found that vets working in an area they perceived was a
low socioeconomic area were much more likely to commit suicide. There are a
gazillion potential reasons for this but further studies are needed: maybe
these vets work longer hours. Maybe treatment recommendations are declined more
frequently. Maybe companion animals aren’t valued as members of the family.
Maybe there is a higher after-hours workload. Less support staff. Low pay. Do they percieve they work in a low SES area because they are seeing everything through depression's inevitable poo-coloured glasses? Is job stress the final straw for those with problems in their personal and home lives? We
really don’t know.

What we do know is that we
do need to examine this further so we can support each other.

If you are heading to the
AVA Annual Conference (May 25-30 in Perth) it’s worth a visit to the Wellness
Stand. Not only can you have your physical health checked (BMI, BP, HR, even a
Q-fever test), you can also complete a questionnaire to determine how stressed
you are.

The conference will also
see the debut of the Australian Veterinary Orchestra, which will be raising
funds for the Veterinary Benevolent Fund and was actually borne from the need
to find a creative outlet. Read more here.

The AVA also runs a
counselling service which members call call anytime on 1800 337 068.

Veterinary Ethics: Navigating Tough Cases

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